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General NPI Number Information
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NPI Number | 1356452155
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Entity Type | Organization
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Legal Business Name | ST MARYS HOLTS SUMMIT PHAR
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/23/2015
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Provider Practice Location Address
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Address Line | 140 NORTHSTAR
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City | HOLTS SUMMIT
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State | MO
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Zip | 65043
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Country | US
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Telephone | 573-896-4579
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Fax | 573-896-4472
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Provider Business Mailing Address
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Address Line | 140 NORTHSTAR
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City | HOLTS SUMMIT
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State | MO
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Zip | 65043
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Country | US
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Telephone | 573-896-4579
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Fax | 573-896-4472
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Authorized Official
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Title or Position | DIRECTOR PHARMACY SERVICES
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Name | DR. JAMES RICHARD STEPP
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Credential | PHARMD
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Telephone | 573-681-3178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2000143682
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License Number State | MO
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